Pelc Marcin, Hryniuk Władysław, Bobiński Andrzej, Kochańska-Bieri Joanna, Tomczyk Łukasz, Pili Daniele, Urbański Wiktor, Lech Marcin, Morasiewicz Piotr
Institute of Medical Sciences, Opole University, 45-401 Opole, Poland.
Department of Orthopaedic and Trauma Surgery, Institute of Medical Sciences, University of Opole, 45-401 Opole, Poland.
J Clin Med. 2024 Aug 9;13(16):4671. doi: 10.3390/jcm13164671.
Up to 75% of calcaneal fractures are intra-articular fractures, which may severely impair foot function and lead to disability. We retrospectively analyzed 21 patients with intra-articular calcaneal fractures who had been treated with the Ilizarov method in the period 2021-2022. The mean patient age was 47 years (range 25-67 years). We analyzed the following functional parameters: foot function with a revised foot function index (FFI-R) questionnaire and the level of physical activity, with the University of California Los Angeles (UCLA) activity scale, a visual analog scale (VAS), and a Grimby physical activity level scale; and ankle range of motion. We observed a significant improvement in the UCLA activity scores and Grimby activity score at long-term follow-up. Functional outcomes based on the FFI-R questionnaires showed an improvement, from 292 points prior to surgery to 127 points at follow-up, = 0.013. The post-treatment follow-up measurements revealed a median dorsiflexion at the treated ankle joint of 20 degrees, whereas that at the intact ankle was 40 degrees, = 0.007. The plantar flexion showed asymmetry, with a median 15 degrees at the treated ankle and 30 degrees at the intact ankle, = 0.007. The median range of inversion at the ankle joint was 5 degrees in the treated limb and 15 degrees in the intact limb, = 0.039. Patients with calcaneal fractures treated with the Ilizarov method are recommended to have a longer and more intensive rehabilitation. The range of ankle motion in the treated limb was limited in comparison with that in the intact limb; however, this did not greatly affect the patients' return to their earlier, pre-injury level of physical activity.
高达75%的跟骨骨折为关节内骨折,这可能会严重损害足部功能并导致残疾。我们回顾性分析了2021年至2022年期间采用伊里扎洛夫方法治疗的21例关节内跟骨骨折患者。患者的平均年龄为47岁(范围25 - 67岁)。我们分析了以下功能参数:采用修订后的足部功能指数(FFI-R)问卷评估足部功能,以及采用加利福尼亚大学洛杉矶分校(UCLA)活动量表、视觉模拟量表(VAS)和格林比身体活动水平量表评估身体活动水平;并测量踝关节活动范围。我们观察到在长期随访中UCLA活动评分和格林比活动评分有显著改善。基于FFI-R问卷的功能结果显示有改善,从术前的292分提高到随访时的127分,P = 0.013。治疗后随访测量显示,治疗侧踝关节背屈的中位数为20度,而未受伤侧踝关节为40度,P = 0.007。跖屈显示不对称,治疗侧踝关节中位数为15度,未受伤侧踝关节为30度,P = 0.007。治疗侧踝关节内翻的中位数范围为5度,未受伤侧肢体为15度,P = 0.039。建议采用伊里扎洛夫方法治疗跟骨骨折的患者进行更长时间、更强化的康复治疗。与未受伤侧肢体相比,治疗侧肢体的踝关节活动范围有限;然而,这并未对患者恢复到受伤前的身体活动水平产生太大影响。